At least 15% of human malignant diseases are attributable to the consequences of persistent viral or bacterial infection. Chronic infection with oncogenic human papillomavirus (HPV) types is a necessary, but insufficient, cause in the development of more cancers than any other virus. Currently available prophylactic vaccines have no therapeutic effect for established infection or for disease. Early disease is characterised by tissue sequestration. However, because a proportion of intraepithelial HPV-associated disease undergoes immune-mediated regression, the development of immunotherapeutic strategies is an opportunity to determine proof-of-principle for therapeutic vaccines. In this Review, we discuss recent progress in this field and priorities for future clinical investigations.
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